Changes With Aging

During the middle and later years, fat tends to accumulate in the lower abdomen and near the hips, even when total body weight is stable. This accumulation, together with weakening of the abdominal muscles, often produces a potbelly. Occasionally a person notes this change with alarm and interprets it as fluid or evidence of disease.

Old age may blunt the manifestations of acute abdominal disease. Pain may be less severe, fever is often less pronounced, and signs of peritoneal inflammation, such as muscular guarding and rebound tenderness (p. 335), may be diminished or even absent.